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NPI Code Detail

MEDICARE: ELIZABETH BRANDON MSW

MEDICARE: ELIZABETH BRANDON MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1073845954
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH BRANDON MSW
Provider Business Mailing Address
First Line : 1801 FOX DR
Second Line :
City : CHAMPAIGN
State : IL
Zip : 61820-7236
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1510 W OTTAWA RD
Second Line :
City : PAXTON
State : IL
Zip : 60957-4090
Country : US
Telephone Number : 217-379-4302
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2010
Last Update Date : 09/10/2019

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Directions to “ ELIZABETH BRANDON MSW” Practice Location

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